HomeMy WebLinkAbout11-09-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~ ~~a^'`~; .~+ '"~ "wE~'~ OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES '•' `~A~p~t~1I5 1~lEh~t~, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~. ~~~~ (r-r~O~~~;~~,xONS AND ASSESSMENT OF TAX
PO BOX 280601 °.~`». ~.~ ! `,/' la '.. .=
HARRISBURG PA 17128-0601
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KATHLEEN SHAULIS E~~~s!~~`~;?_f~;~°+~ ~•> ~~
SHAULIS LAW OFFICE
PO BOX 1229
CARLISLE PA 17013
REV-1547 EX AFP CO1-09)
DATE 11-02-2009
ESTATE OF HENRY ROBERT W
DATE OF DEATH 11-22-2008
FILE NUMBER 21 08-1207
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 01-01-2010
(See reverse side under Objections)
Amount Remitted -~
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG T_HTS LINE _ ~ R_ETA_IN LOWER PORTION FOR YOUR RECORDS ~ _ ____________ __
REV-1547 EX AFP CO1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR -
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HENRY ROBERT W FILE N0. 21 08-1207 ACN 101 DATE 11-02-2009
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
C1) .0 0 NOTE: To insure proper
(2) .Q 0 credit to your account,
submit the upper portion
C3) .0 0 of this form with your
C4) .00 tax payment.
C5) 251 , 292.43
C6) .00
~~) .00
Cs) 251, 292.43
APPROVED DEDUCTIONS AND EXEMPTIONS: 13,057.99
9. Funeral ExpenseslAdm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .0 0
11 . Total Deductions (11) 1 ~ • DS7 - 99
238,234.34
12. Net Value of Tax Return C12)
10,0 0 0.0 0
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13)
228,234.34
14. Net Value of Estate Subject to Tax C14)
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
00
00
. 00
15. Amount of Line 14 at Spousal rate Cis) •
=
X
16. Amount of Line 14 taxable at Lineal/Class A rate C16) • 00 X 045 = . 00
17. Amount of Line 14 at Sibling rate C17) 152,156.23 X 12 18,258.75
18. Amount of Line 14 taxable at Collateral/Class B rate C18) 76, 078.11 X 15 = 11,411 .72
19. Principal Tax Due C19)= 29, 670 .47
IA (~K Ul I,•
PAYM N
DATE
RECEIPT
NUMBER
DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
02-12-2009 CD010895 1,473.68 28,000.00
05-13-2009 CD011224 .00 196.83
TOTAL TAX CREDIT 29,670.51
BALANCE OF TAX DUE .04CR
INTEREST AND PEN. .00
TOTAL DUE .04CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN ~1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)